Medical Billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for services rendered by a healthcare provider. The same process is used for most insurance companies, whether they are private companies or government sponsored programs
This course introduces the student to health insurance and reimbursement. In this course the student will become familiar with common medical billing practices, the health insurance industry, legal and regulatory issues and differences in reimbursement methodologies. The student will learn principles of medical billing related to proper claim form preparation, submission, and payment processing, and the follow up process. This course is recommended for anyone who is preparing for a career in a medical billing department at a physician’s office, clinic, or other healthcare entity, and as a claims examiner for insurance carriers.
Data Entry of all charges within 24 hours.
- Submitting electronic and / or paper claims to both primary and secondary insurance carriers.
- Monthly Cash Statements and patients and Insurance Verifications.
- Soft Collections after cash balance exceeds 70 days past due
- Mail out a series of three collection letters.
- Make 3 phone calls to patients who do not respond to collection letter.
- Refer all remaining balances to client for analysis.
- Entering practice information into software program, to include lists of all insurance carriers, fee schedules, ICD-10 and CPT-4 codes.
- Accurate ICD-10 and CPT coding of your services
- Follow up on claims at 31 days and An in-house pre-collection unit
- Appeals and Denials
- We will follow insurance guidelines for all appeals and pursue all avenues to receive payments.
- If the appeal process has been exhausted, we will forward the information back to the client for review and analysis
- Posting of payments received from insurance companies .